Suellen Miller (left) fields a question from a colleague as Elizabeth Butrick, also of the Safe Motherhood Program, tries on the antishock garment on a meeting room table Tuesday October 15, 2013 in San Francisco, Calif. UCSF researcher and nurse midwife Suellen Miller has adapted an "antishock" garment to reduce hemorrhaging after childbirth, which will be especially useful in developing countries.

Photo: Brant Ward, The Chronicle

Suellen Miller (left) fields a question from a colleague as...

Image 2 of 3

The LifeWrap acts like a body tourniquet and allows blood to be directed to vital organs.

Photo: Brant Ward, The Chronicle

The LifeWrap acts like a body tourniquet and allows blood to be...

Image 3 of 3

UCSF researcher and project director Elizabeth Butrick wears the anti-shock garment which concentrates pressure on the abdomen area Tuesday October 15, 2013 in San Francisco, Calif. UCSF researcher and nurse midwife Suellen Miller has adapted an "antishock" garment to reduce hemorrhaging after childbirth, which will be especially useful in developing countries.

New mothers in remote regions of developing countries who experience the relatively common complication of bleeding after giving birth often die before they get medical help. But a simple, neoprene garment developed for postpartum use by a UCSF researcher is saving lives.

It looks like a strange wet suit - one that's segmented and fastens with Velcro around the legs and lower abdomen - and acts like a body tourniquet to restrict the blood in the lower extremities and direct it to such vital organs as the heart, lungs and brain.

An inflatable version of the device was developed and used to reverse shock in critically injured soldiers during the Vietnam War, and NASA later created a non-inflatable form of the garment for use in space.

A UCSF professor and nurse midwife, Suellen Miller, came up with the idea to use a non-pneumatic, antishock garment to help women who live in areas where they lack access to medical care. The idea was to use the device to prevent them from going into shock, oxygen loss and organ failure due to excessive bleeding during birth.

"I wasn't sure it would work. It was just an idea," Miller said. "I figured if it worked and it's so simple and inexpensive, why isn't it already being used?"

Leading killer

Postpartum hemorrhage is the leading cause of deaths in mothers, accounting for as many as 100,000 deaths a year worldwide, according to World Health Organization statistics. Bleeding occurs for a variety of reasons, such as failure of the uterus to contract or a rupture, but the condition can usually be resolved in a basic medical setting with medications, surgery or a blood transfusion.

Miller, who has worked for more than a decade to study it in clinical trial and encourage the widespread use of the garment, is finally getting the traction she needs.

The World Health Organization added the garment to its influential list of recommendations to treat postpartum hemorrhage last year. PATH, an international nonprofit global health organization, named the device one of the top 10 breakthrough innovations that can save mothers' lives.

Clinical research has also supported the device's effectiveness. In a study published Wednesday in the online journal Plos One, Miller's trial, conducted simultaneouslyin Zambia and Zimbabwe, showed use of the garment could reduce death by as much as 54 percent.

Small but significant

Miller admits the study has limitations. Because of a small sample size involving just 880 women, researchers were unable to reach their statistically significant goals during the five-year study. But the results still showed a more than 50 percent reduction in death for women who were quickly treated with the device.

The results are similar to a 2006 study Miller conducted of women in Egypt, she said.

"For mortality to have this large of an effect, it's sort of indisputable," Miller said.

Dr. Mario Merialdi, coordinator of the World Health Organization's reproductive health and research department, agreed that the garment's effectiveness isn't really in question. "When you have an intervention that always produces the same results in different settings and studies, that gives you confidence in the results," he said.

"Now it's important to move forward and start to work with companies that will produce the device and make it available in large quantities" for use in more countries, Merialdi said.

Miller said she found a company in Hong Kong about three years ago that can make the garment, sold under the brand name LifeWrap, at a relatively low cost while maintaining the quality. She said it sells for about $60, which is much lower than the several hundred dollars it can cost from other companies.

The garment can be used up to 50 times before it needs to be replaced because solutions used to clean it will eventually degrade the materials, she said. She said the technique to properly wrap a woman in the garment is easily learned and can be taught to people without medical training.

"It doesn't cure anything, but it buys time. And buying time is very precious in countries where roads are bad and ambulances are few and far between" he said.

The device has been used in at least 16 countries including the Philippines, Bolivia, India and Haiti. Miller said the garment has potential for use in the United States, particularly for home births and among Jehovah's Witnesses, who refuse blood transfusions because of their religious beliefs.

But the need is clearly greatest in poor countries where the risk of death from postpartum hemorrhage is about 1 in 1,000 compared with 1 in 100,000 in a developed nation.

Miller remembered a case in Nigeria in 2004 in which a woman, who had been bleeding for two days, was brought to a hospital without a detectable pulse and was presumed dead. She was immediately wrapped in one of Miller's garments.

"Within a few minutes, her eyelashes started to flutter," Miller said. She said the woman recovered, and her family gave her a new Nigerian name that means "someone who's been to heaven and back."

More information available online

For more information about LifeWrap, the antishock garment used to reduce maternal deaths from postpartum bleeding: www.lifewraps.org/lifewrap.